【摘要】 目的 探讨主动脉窦瘤破裂（RSVA）的临床特点、诊断及外科治疗方法。 方法 2004年1月-2009年12月对28例RSVA患者在体外循环下行RSVA修补术，同期行室间隔缺损修补术18例，房间隔缺损修补术4例，主动脉瓣成形术2例，主动脉瓣置换术4例。术后随访3个月～6年，平均32.4个月。 结果 28例患者均无手术死亡和残余分流。失访4例。心功能Ⅰ级20例，Ⅱ级4例；复查心脏彩色超声心动图无主动脉窦瘤复发或残余分流，主动脉瓣轻-中度反流2例。 结论 外科手术是RSVA的最有效治疗方法，窦瘤破口直径 gt;0.5 cm者宜用补片修补。伴有中或重度主动脉瓣关闭不全时需根据主动脉瓣病变程度以及手术者经验决定，必要时需放宽换瓣指征。
【Abstract】 Objective To evaluate the clinical characteristics, diagnosis, and surgical treatment of ruptured sinus of Valsalva aneurysm (RSVA). Methods Twenty-eight patients with RSVA were treated surgically in extracorporeal circulation. Repair of RSVA with patch were taken in all patients while closure of ventricular septal defect (VSD) in 18 patients, closure of atrial septal defect (ASD) in four patients, aortic angioplasty (AA) in two patiens and replacement of aortic valve in four patients. Results There was no death and no residue leak after operation. The patients were followed-up for 24 patients, ranged from three months to six years, with the average 32.4 months. The cardiac function of 20 patients was found to be of NYHA classⅠand four patients of classⅡ. Review the heart colour echocardiography, there was no residual tumor or sinus and aortic regurgitation light-moderate in two patients. Conclusions Surgery is the most effective treatment for RSVA, the breaches of sinus tumor in diameter gt;0.5 cm is used to repair. When the patients with moderate or severe aortic regurgitation, whether it is necessary to relax in disc indications depends on the degree of aortic disease and performer’s experience.
Citation： FENG Gang,CONG Wei,LIU Shengzhong,GAN Chongzhi,CHEN Fan,ZENG Fuchun. Surgical Treatment for Ruptured Sinus of Valsalva Aneurysm. West China Medical Journal, 2010, 25(8): 1445-1447. doi: Copy